Implants & Wig-Free

Well, things have been bopping along here. We just undecorated from Christmas which always makes me kind of sad. And when I say "we," I actually mean my darling husband did all the work while I was over helping a friend paint bedrooms at her new house. You would think I would be grateful when I came home to find it all done, but instead, I put on a sad face and mournfully sang, "Where are you Christmas? Why can't I find you?"

In November, I celebrated my 42nd birthday. Surviving cancer has made it a lot easier to admit how old I am because, hey. I made it this far! I also played piano in the pit orchestra for the musical at the college where I work. We did "How To Succeed in Business Without Really Trying."  I've found I love being the rehearsal accompanist for these shows. It's a great way to connect with some of my voice students in a different environment. Also, I just love musicals. They're fun.

Like everyone else, we had a busy December with Christmas as a highlight. Guess what I got for Christmas! An accordion! My mom thinks I'm crazy. I don't think she gets me. Christmas Eve is one of my favorite days of the year, and I got to play cello for all 4 of our church services. We were also overwhelmed with thanksgiving when our friends unveiled a secret that they'd been plotting for a mere 5 days: they took up a rather sizable collection to help us pay for a replacement car for us! We were stunned. What a sweet blessing!

So here we are in January. I have an opera coming up in 3 weeks. I am doing "Die Fledermaus" as a concert opera on January 25 with Sounds of South Dakota, Inc. (click on the link if you want to buy tickets!)

Oh, and I'm also having implant surgery in a couple of days. My last post was about being done with the expansion phase, then I had to wait 3 months before this next step in the process. It's time to get rid of these hard baseballs and replace them with something more "smooshable." I understand that it's a much less invasive process than the mastectomy/ reconstruction surgery I had in August. It will require an overnight stay in the hospital (I thought it was outpatient. Bummer). My surgeon says I should anticipate about half the time to heal that I took last time. Of course, I only took two weeks off rather than the suggested 4-6 weeks. I don't actually go back to teaching at school until February because I don't teach during J-term, so all I'm doing for work right now is teaching a handful of lessons at home anyway. I cancelled one day, and will take a little time off over the weekend, but anticipate that I should be able to teach my evening lessons by Monday after the surgery on Wednesday.

I opted for silicone implants rather than saline. Silicone was suggested by my surgeon, for my bony body-type, and is what she prefers. It's got a more natural feel to it. The danger of rupture is very small with both kinds, but if a saline implant ruptures, it will be very obvious. You deflate like a balloon- on one side of course, because the surrounding tissue absorbs the saline.  If the implant is not replaced within 24-48 hours, the tissue may have to be expanded again before replacing the implant. If a silicone implant ruptures, the silicone just stays within the scar capsule surrounding the implant, and often you can't tell if it has even happened. This is called a "silent rupture," which kind of makes me wonder how loud a regular rupture is! I will have regular MRIs every 2-3 years to check the status of my implants, so I guess that replaces mammograms for me in the future.  I asked my surgeon how often she has had a rupture, and she said one time in the over 2,000 she's placed, and that patient had a lot of other problems. I suggested she had spiky tissue. That's probably what it was. Or maybe acid blood. That's a thing, right?

I have the option of going in for a final surgical procedure after I'm all healed up from this one: nipple reconstruction. I think I'm going to pass on that. I mean, you spend your whole life trying to cover them up. Why would I want fake ones that aren't even functional? There is also the opportunity to get tattoos to simulate areolae. They call it 3-D tattooing. I like to think of it as trompe l'oeil. Seems fancier that way.

I will have two drains for about 10 days instead of the four I had last time, and I'll be on lifting and driving restriction for a while. I'll be wrapped in ACE bandages for a bit, but hoping to have a nice shape for the opera because hey, fancy dresses!

Oh, and I stopped wearing my wig last week. I have had very short hair for quite a while, but it was just a buzz cut, not a style. I unveiled my short, salt & pepper croppy do on Sunday, but on Monday, I got it bleached white-blonde. It's totally rock & roll now. My hair is so black, thick and growing so aggressively, that I swear I had black roots within 20 minutes! I won't leave it this color, but it's what I wanted for the super-short stage. And when else in my life am I ever going to have "virgin" hair again?! I've been dying it since high school!

So here's another celebrity look-alike photo: Me & Annie Lennox.

                                          source: www.vashtie.com

See? Rock & Roll!

One last thing, we had an appointment for our son, Xander with an ophthalmologist this week to check and see if his eyes showed any signs of Marfan's Syndrome. We are happy to report that they do not! The only way to know for sure is to visit a geneticist, but this is a very good sign. We will revisit the surgeon in April, and schedule his pectus surgery after that. (The back story on this is located within this post).

Thanks for following my posts. I can't believe how many people read these things. I really appreciate all the encouragement and support from you all. I've learned so much through this process, and if I can be a help to others going through a similar situation, then I am thankful for that.

Happy New Year!

Done Expanding

*WARNING: This blog post is all about boobs. My boobs specifically. And not in the sexy way. It may fall into the category of Too Much Information for you. Don't say I didn't warn you.

Yesterday, I had my last appointment with my plastic surgeon for the purposes of expansion. I have decided I don't need to go overboard with these things. A nice B-cup is fine with me. I've said all along, I just want to be the size I've always pretended to be- thanks to really padded bras.

OK, so here's some information about expanders that I didn't really know going in:

They are not natural. Well, duh.  But they don't look or feel natural at all. They are hard like baseballs (you'll notice if you hug me too tight), they don't move AT ALL, and they sort of look like they were stuck on my chest like Play-Dough lumps.

They are spaced far apart. They really feel like they're sitting in my armpits. My doc says that is intentional, so that you don't accidentally end up with a "uni-boob." Assuming that means that the muscle over the sternum might pop out to the same place as the intentionally expanded pectoral muscles (remember that the expanders go BEHIND the pectoral wall). The wide-placement of them does make it uncomfortable to sleep on my side.

They don't move. Did I mention that? I can jog, jump on a trampoline, or run up and down the stairs (all theoretically- I don't really do any of those things), and these puppies wouldn't move at all. No bra needed. So that's something.

They are uncomfortable. The expansion process goes like this: once a week, I go into the surgeon's clinic, she locates the magnetic port with this little doo-hickie, then pokes a rather large-bore needle attached to some tubing, a saline bag & a large syringe into my already numb skin. I have not felt the needle poke at all, due to the damaged nerves from the surgery. Then she pushes in the saline. She had said originally that they would start small- 25 cc's and work up to about 50 or possibly even 100 cc's at a time. I discovered that 40 cc's was too much after two rather uncomfortable weeks in a row, so we backed it down to 25, which was apparently my magic number. I was on a mild muscle relaxant and some pain-killers for the whole process, which took about 6 weeks. Happy to be done with all those drugs as of yesterday.

They look weird. Did you know that the mastectomy scar goes right across the middle line of the breast? The nipple no longer exists. They make a football-shaped incision around the nipple, then dig out all the breast tissue (I envision a small ice cream scoop. I'm probably wrong), place the expander in roughly the same place, but behind the muscles, then sew it up, or glue it together or whatever- there are no visible stitch marks. They kind of look like they're sleeping. I call them my Sleeping Giants. I was concerned about possible stretch marks due to the rapid shape change. The doc assured me that I would probably not get them, but I did. Mostly right near the center of the incision where they had to pull that skin up tighter to create that straight line. (I'm not showing you a picture of this. You're welcome.) They also are lumped on the chest like big blobs of clay. Not terribly graceful at this point. My shirts keep slipping up and sitting on top of the shelf they create.

Well, now they don't look that impressive. 

Maybe I should keep expanding...

Plus, there is a tendon or something that goes from the top of your armpit down to your chest, which is now anchored on top of my breast instead of behind it. So when I reach forward, I get this weird stringy triangle thing that looks pretty freakish because I'm already so bony.

Ick, maybe don't stand like that.

Haha! I tried to get a better picture of this:

Eew! Freakshow! 

I look all muscle-bound or something! 

Trust me, I'm not.

They may expand differently. Mine are not symmetrical. The left one expanded out flatter and wider, and the right one expanded out forward. It's not really obvious to the casual observer (and most people are too polite to even look at all), but it's obvious to me, my husband and my plastic surgeon!

These things are all temporary. I have been told that all these things are just a part of the process, and the real implants will look and feel natural, be movable, I will be able to smoosh them together and make cleavage (for the first time in my life!), and they will be much more symmetrical when all is said and done. The next step after the implant surgery is tattooing. That's right. They tattoo the nipple and aureola back on (again, no pictures). You can elect to have a artificial nipple inserted, but I don't think I want that. We spend our whole lives trying to cover that up! The 3-D tattoo will be fine for me.

So that's about it for now. I will have the implant surgery in January, while I'm off work for J-term. She said I should plan for a couple of weeks off at least- or half the time I took off for the last surgery.

"How much time did you take off last time?"

"Two weeks. I know you recommended 4-6, but healing is boring. I would have gone nuts." She laughed and confessed that after her c-section, she was back in the office doing expansions the next week. Just brought the baby along. At least she understands my need to keep moving. I don't anticipate this part to be that big of a deal. Maybe I'm wrong. I'll let you know afterward. :)

In non-boob related news, I have this much hair:

Should be able to go wig-free by my birthday next month. 

Wonder if I will have enough hair to hold my birthday tiara in place? 

It still looks like I have an abnormally small head, and it's really cold to go without covering.

Also, I have tiny little eyelashes growing in to fill in the bald spots along my lash lines.

OK, you can't see them, but they're there. 

Right along the bottom outer edge. 

Just trust me on this one.

I'm looking forward to Halloween simply because it means costumes! (No scary stuff at our house) Maia's Fall Festival is tonight at the elementary school. I may have to finally wear that blonde beehive out in public.  In other words, life is very much back to normal around here! 

I'm A Survivor!

Just wanted to post a quick update. I saw my surgeon for a follow-up appointment this afternoon, and it is official- NO RADIATION! I had kind of deduced that from one conversation I had with my oncologist's scheduler, who was at the conference where the doctors all discussed it, but I never heard back from the doc. What a weight lifted! I didn't know I was still worried about it until I heard him say for sure.  My stomach leaped and my shoulders released. I think I laughed out loud.  Dr. Dosch said, "You've done great!" I said, "I know!!!"

I feel like I'm over the treatment phase and firmly in the recovery phase. I finally feel like I can truly say,

"I am a cancer survivor." 

My body knows it too. I have stopped breaking down and I'm building back up. The first thing to return to normalcy was my mouth. About 2 weeks after my last chemo treatment, I had my taste buds back. It happened between each of my 6 treatments, so that one didn't surprise me. I had watery eyes and twitchy eyelids for about 6 weeks, and that went away after my surgery. I guess I finally got enough sleep or something! It's nice to no longer have the "taxotears."  This week, my hair started to grow back. People keep asking if it's growing back differently. I don't know. I've never shaved my head before this. So far, it looks pretty peach-fuzzy.

I still have icky fingernails, but as long as I keep them very short and painted, they don't bother me too much. My fingertips have regained feeling (hooray!!!)- in fact, I'm back at work as of last week, and playing piano every day. I have not regained my menstrual cycle. That's something I probably won't ever get back- intentionally on the part of my treatment plan. That doesn't bother me, but the side effects of menopause aren't that much fun.

After my appointment this afternoon, the surgeon said he doesn't need to see me again for 6 months. So I went out to make my appointment. The scheduler said, "That will put us in March." I flipped my phone calendar to March and my heart skipped a beat.

6 months ago this week was March 20. Diagnosis Day.

6 months ago today, I had that fateful biopsy.

6 months.

I am so very fortunate. Some people battle this disease for years. I caught it so early. I always say it was a flat-out miracle that I even went to the doctor. I never go to the doctor. But I had an uneasy feeling about that lump. I was so invincible. I never thought this would happen to me. But I have learned so much about the power of prayer, and the beauty of community through this experience. Thank you for reading, for praying for me, for bringing our family meals and sending money & gift cards. You have blessed us in more ways than we can count.

I mentioned earlier I went back to work last week. Today was the last day of meals provided by friends. Our house is back to being a disaster, and we are back to normal around here. We will look for every opportunity to "pay it forward."

I won't be free of the cancer center for 7 years. I still have to go every 3 weeks to have a Herceptin infusion for another 6 months, and next week, my oncologist will put me on a pill called Tamoxifen for the next 10 years- which will keep me in menopause until I'm pretty much old enough to stay there. They will continue to keep a very close eye on me. I have only just begun the recovery phase.  After 7 years, they will declare me cancer-free and kick me out the door.

We will celebrate every milestone along the way.

Back to Work! And More News About Xander

Well, I did it. I went back to work on Monday, just shy of 3 weeks after my surgery. I had 8 students; 4 in the morning, then a two-hour lunch break and 4 in the afternoon. Now that all 20 of my USF kids are signed up, I will actually do 10 on Mondays, followed by student recital at 4 pm most weeks. I usually do another 4 or so at home in the evenings, but I'm not starting up my home lessons until next month. I taught another 5 on Tuesday afternoon (followed by a hard nap each day). I will also teach a handful on Thursday mornings. It's not a bad load. 1 full day and two half days per week.

Oh, and I may have said "Yes" to being the rehearsal accompanist for USF's upcoming musical, "How To Succeed in Business Without Really Trying."

And by "I may have said 'Yes,'" what I really mean is, 

I went and introduced myself to the new theatre 

director and asked if I could be the rehearsal accompanist 

for the musical... I can't help it! It's like an addiction. 

The show is in November. Auditions (which I will be sight reading- GAH!) are next week. I'll keep you posted! :D

Anyway... here is where I currently stand in my treatment: I will continue to go to the Prairie Center and get a Herceptin infusion once every 3 weeks. Oh, and while Dr. Dosch was doing my mastectomy, he went ahead and replaced my faulty port, so now I have one that works again. Woo! I went to the plastic surgeon on Friday of last week and got my first expansion. They showed me what the expanders look like:

It's folded a little differently than this, 

but that is a pretty rigid plastic material

This explains why it feels like there is a large lump of clay under my skin. The circle on the top is the magnetic port, which is where it's safe to poke a needle into for expansions. They use a little magnetic finder, mark the skin, then poke a needle in and basically use a syringe to fill me with saline. There's more tubing involved, but that's the gist of the process. The reason many women say this hurts so bad is because of the amount they are given. I was only given 25cc's on each side this time. Next time will be 40, then 50, maybe 60 and possibly as much as 100, but I don't have to take that much at a time if I don't want to. It is necessary to take muscle relaxers for a few days following a fill-up, because the expanders are behind the pectoral muscles. I didn't even feel the needle poke because I don't have functioning nerve endings in that part of my body anymore, so that's a plus.

The expansion process takes about 3 months on average, but I can do it at whatever pace I want to. Then after I decide I have been expanded enough, they go one larger (it's like going "one louder" on your guitar amp), then leave me alone for 3 months to give the muscles time to adjust to their new shape. After 3 months, I can have the second surgery to take out the expanders and put in the actual implants, which are supposed to be much more flexible and natural feeling.

So that's where I am in the process. Now for an update on The Boy.

Today (Wednesday), we took Xander to have a CT scan before school, then let him start and finish his day at school but picked him up for a couple of hours in the middle of the day to visit the surgeon, Dr. Bufo. We were very impressed with this guy's knowledge of pectus excavatum and the number of cases he has treated. Here are a few things we came away with from today's meeting:

• This is not something that Xander will outgrow, but rather that it will get worse as the years go by. He says that Xander will probably go through another growth spurt, or possibly two (Geesh! I thought it was hard to find pants for him now...) and that the pectus will continue to get worse, not better. 
• He showed us on X's chest how you can see his heart beating very close to the skin while he is at rest. While his heart is not compromised yet, it will get pushed farther and farther to the left until it's almost in his armpit if left untreated. Matt took video of this phenomenon because he told Xander, "You're going to want to see this freak show." 
• Dr. Bufo explained the surgery called the Nuss Procedure that he is an expert on. He actually studied and worked with the inventor, Dr. Donald Nuss. The nuts and bolts of the surgery can be found in this link. Basically, they will surgically insert a bar through Xander's chest cavity that presses the sternum forward. There is a 5-6 day hospital stay involved.
• Dr. Bufo said that the ideal time to do this type of surgery is when a boy is 12 because the cartilage in his ribs has not calcified into bone yet. Every year they wait, it gets harder to do, more painful, and less effective. Xander is still in a safe age range.
• The C-T Scan that they did on him this morning showed that his heart is currently not in danger- it measured the space from the sternum to the spine. Likewise, the Echocardiogram also showed no defects, but Bufo says if he did a lung function test with a pulmonologist, it would probably show that his lung function decreases with prolonged cardio activity, according to the way Xander described his cross country experience last year.
• The surgery will take 6 weeks of recovery time, so he wants to wait until school is out. (Let's see if he has Mom's resiliency. I told him maybe I could do my implant surgery at the same time and we could race to see who recovers first!) There is no rush, it is very slow-developing. So we made an appointment for a day when they don't have school in February to test him again, and make sure that insurance is going to cover the procedure, then we will plan to do the surgery in the summer so he doesn't have to miss school. 
• I asked if he had any concerns about Marfan's Syndrome, which Dr. Sami, the cardiologist, had mentioned, and initially he dismissed it pretty quickly, but then when I got home, I got a call from his nurse that said Dr. Bufo was doing his dictation and noticed the note from Dr. Sami about the enlarged aorta, and asked if we would take Xander in to see a pediatric opthamologist, Dr. Tufty (interestingly, a Sanford doc), to tell us for sure whether he has Marfan's or not. Apparently, it's very obvious in the eye to the trained observer. 

So we are not in any hurry to start this whole process, but are methodically moving toward a resolution.  Meanwhile, here come a whole 'nother army of medical bills... yay...

And to think- this is our "easy" kid!

I have to tell you how proud I am of Xander though. Before we saw the surgeon, we were under the impression that the surgery was kind of optional, which it still is, but that it was more cosmetic than medically necessary. He said that given the choice, if it was just going to look weird but not be a real danger to him, he wouldn't bother. "I'm comfortable with who I am."  (WHAT!?! From a 13 year-old?!) I told him that maybe someday, you know, FAR down the road, maybe a girl might want to look at his chest without a shirt on... AFTER you're married or something. And he said, "If she doesn't like the way I'm made, then she's not the girl for me." (Aw! I hope he's able to instill such self-confidence in the "girl for him" somewhere down the road)

I just wanted to get that out there because his whole attitude might change when he's 15 and girl crazy. But for now, I have a psychologically secure teenager. It blows my mind!

Of course, this attitude shouldn't surprise me. This is the kid who regularly wears a T-shirt that says, "WARNING: You Can Go Blind From My Pure Awesomeness"

That's my boy!

Recovery Update & Xander News

It is so good to be home! I have been progressing very well. My main job has been to keep track of which medications to take when. I made a little spreadsheet to keep myself on track (and to avoid overdosing!) I will tell you this, I am NOT waiting 4-6 weeks to go back to work. 3 will be just fine, and will make my life considerably less difficult than if I had to scrunch the semester into a shorter time period.

We came home from the hospital a week ago on Friday evening, and my Mom stayed with us through Sunday afternoon. I was able to get up and go to church on Sunday morning with no problem. I have taken naps when I need them, and generally kind of putter around and do low-impact stuff around the house.

Monday, the kids went to school and Matt went to work. I was left home alone and tried to do some baking, but reaching into my baking cupboard was a stretch beyond what was comfortable for me. I did get a pan of banana bars made, but was VERY grateful when someone showed up at the door with dinner because I was wiped out!

Tuesday and Wednesday, I ended up going with Matt to work at the church just to keep myself out of trouble. He gave me a little project to work on which mostly consisted of writing and cutting. I felt much better those two days.

I'm pretty tired of not driving. I dislike having to be chauffeured around like Miss Daisy. Also, I am a horrible backseat driver. Mom says maybe Matt should teach Xander to drive, not me. She's probably right.

Speaking of Xander (our 13 year-old son), Thursday we took him to the doctor. He has developed a pectus in his chest during his adolescent growth spurt, that looks something like this:

Xander is clearly more intelligent than this boy. 

You can just tell by the vacant look in his eyes.

His lower ribs really flare forward more than this drawing, making the depression appear deeper than it is. We have been concerned that it was impairing his heart/lung function when he was exercising, as he gets winded really easily and it scares him a bit. Obviously, it is not life-threatening, but we finally got insurance that would cover the doctor's visit, so we took him in.

The pediatric cardiologist that he saw didn't seem too concerned about the pectus itself- he says it has to be really deep to move the heart like in the drawing above, but he saw several things that point to the possibility of Marfan Syndrome, specifically his tall, lanky stature, the stretch marks on his back (stretch marks?! I thought those red lines were just scratches!), the fact that he wears glasses and some of his joins hyper-extend. Marfan Syndrome is a connective tissue disorder than can effect several different parts of the body, specifically the heart, blood vessels, joints, bones and eyes.

If he has this, it is very mild.  It is a genetic disorder, and no one on either side of our family has it. Most of the characteristics above can also be applied to me: tall(ish), lanky, with bad eyes and joints that hyper-extend. They did an Echocardiogram, which showed that his heart is functioning perfectly, but he has a slightly enlarged aorta. At this point, it is just something to keep an eye on. They will measure it again in a year and see if it grows proportionally with the rest of his body, or gets out of control.

They also set up a CT scan and a visit with a surgeon for a couple of weeks from now. The cardiologist that we talked to said that if Xander is really self-conscious about the dip in his sternum- and it is very noticeable, it looks like he took a cannonball to the chest, that psychological reasons are enough to have the area repaired surgically and still be eligible to be covered by insurance. He is at a good age to have the surgery, as his cartilage is still very flexible.

I didn't really get a chance to talk to Xander about this last night because of his activities, so this morning, I asked how he was feeling about it all. He said it was good to know that his heart is just fine, and he's safe to do most physical activities- but has an excuse not to do any serious weight-lifting sports like wrestling, football or hockey. I told him that surgery is an option, and it's kind of up to him. I don't want him to be so self-conscious about it his whole life, and to say, "I could've had surgery when I was a kid, but my parents wouldn't pay for it,"* when he's an adult.  We're going to let him think about it for a while. There's no rush. We'll let you know what happens with that as things progress.

*(you have to use a sullen teenager voice in your head when you read that part)

Anyway, back to me.  :)  Here's me today:

the ruffles on this shirt hide a multitude of weird problems

(AKA, non-existent breasts and the drains around my tummy)

Today (Friday) is Matt's birthday (yay!), and I had two doctor's appointments scheduled (boo!). At 9 am, I went in to the plastic surgeon's clinic and had my last 2 drains removed. I was worried that it was going to really hurt, as I've heard some horror stories, but it was fine (whew!). My whole chest area is permanently numb now, so that gives me an advantage in any further treatments I will have. Which will hopefully just be the expansions from here on out. (Well, and the final implant surgery, and then possibly tattoos. We'll talk about that later.)

I say "hopefully" because when I went to the breast surgeon this afternoon, he said that there was about a 1 cm visible tumor that he removed with the breast tissue. I asked how this could be, since the MRI showed that it was only 3 mm. He said the MRI only picks up the solid core of cancer cells, but the visible tumor was significantly larger than that (I might not have the details quite right here). He is concerned that the margins that he removed around the tumor cells might not be enough and I might have to do radiation.

I.do.not.want.to.do.radiation.

I just want to be done with this! Also, radiation messes with the reconstruction process. And radiation causes cancer. "You have cancer? Here's a treatment, but the side effect is more cancer!"* I don't like it. They're really going to have to do some convincing to get me on board with this.

* (you have to read this part in a game show announcer voice)

They are going to present me at Breast Conference next Wednesday, Sept. 4, and as a team decide whether the ongoing Herceptin treatments will be enough or whether they will have to go the more aggressive radiation route.

And you thought you were done praying for me!

So here are the two specific requests that I have:

1.) For Xander's health and the possibility of surgery as described above.
2.) That I will not need radiation. (Please, oh please, oh please, oh please!) You can target prayers for the doctors making the decisions on Wednesday, Sept. 4 (I don't know what time of day, probably early).

Thanks once again to those who have sent money and gift cards. You have eased our financial fears through this stressful summer. We are so very grateful!

I am heading back to work on Sept. 9, and am excited to be getting back to "normal." I got a preview of my USF student load today, and I already have 15-17 students, plus three that have to finish incompletes (AKA senior recitals) from last semester. And there will probably be more once the semester starts next week.

I have enjoyed the unstructured pace of my summer, but it's time to go back to being a productive member of society again.

Post Surgery Update

Thank you to everyone who prayed me through! I had a very successful surgery, there was no sign of the tumor, and no trace of cancer in the lymph nodes. I AM CANCER FREE!!!  It's officially official!

I am recovering quickly. Yesterday afternoon, I was a hurtin' unit after they wheeled me over from recovery into my hospital room. My pain shot up to an 8 or 9 on the pain scale, and it got a bit out of control on me. So thank you to those who visited yesterday, and I apologize for not being at my best.

Matt & I slept deeply but in short bursts through the night. I swear I got up to pee about 6 times. Matt slept on a nifty little single hide-a-bed in my room. He and the overnight nurse had to help me each time I got up. I had to retrain my urinary tract to do its thing after having a catheter during surgery. Oh, and here's a little tidbit from the "bet you didn't know this" file: Before surgery, they injected a radioactive dye into my breast to help the surgeon locate and extract the sentinel lymph node for biopsy. It turned my urine blue! Tidy Bowl blue. Well, it lightened up to a scope green, and then a pale spring green over the course of about 12 hours.

I came out of surgery with a thick Ace bandage wrapped around my chest, with 4 drains coming out of my sides. I think the bandage comes off tomorrow (2 days post- surgery). I hope so! It is really itchy. Two of the drains will be removed when the plastic surgeon comes to check on me in the morning. I will go home with two still attached, and have those removed next week at a follow-up appointment.  The drains look something like this:

This is not my tummy. I'm not showing you that.

They pull the excess fluid out of the surgical incisions using suction. I explained it to Maia this way, "It's kind of like when you want to fill a rubber ducky with water in the bathtub, so you squeeze all the air out of it, then put it underwater to fill it up." I think they should make them out of rubber duckies to give your surgery a more whimsical feel. What do you think? I should patent it!

I was given a pain pump to administer my own narcotic drip through my IV yesterday and overnight. It helped an awful lot, but by about noon today, I didn't need it anymore. I am currently on 3 oral medications:  a muscle relaxant because the pectoral muscles can spasm from being stretched, an nsaid, and a narcotic, all of which will go home with me tomorrow. I am staying ahead of the pain so far, which is very important.

I cannot believe how fast I am recovering. We'll see how I feel in the morning, but I went from slowly shuffling on shaky knees down the hall, attached to an IV pole and an escort on either side of me last night, to today where I was unhooked from the IV, fully dressed and walking easily on my own down to the small cafe they have on this floor to eat all 3 meals. This evening I am comfortably sitting up, fully dressed in my own cozy jammies, wearing my hair and generally feeling 100 times better than I did 12 hours ago.

Here's me this afternoon:

Of course, you can't see the bandages or the drains, the bald head or the nasty fingernails in this picture, but they're not what I'm all about.

Yesterday morning, as I was checking into the surgery center bright and early, the nurse doing my initial paperwork looked at me quizzically and said, "Are you the blogger? Were you the one with the news crew last time you came in here?" I said I was surprised she recognized me because my hair was so much different the last time I was there (to get my portacath inserted in April). She was not my nurse last time, but she said she recognized my smile and my laugh.

I can live with that. I pray that deep and abiding joy will always be something that defines me.

Going Under The Knife

Well, the big week is here. I have surgery scheduled for Wednesday morning.

Many people have caught me and told me they are praying for me this week. I can't tell you how much I appreciate that. I have to say, your prayers are doing great things!

A couple of updates:

#1- Fingernails: They are doing better! I know you were concerned. I know it's a small thing, but I really feel like God is answering our prayers about this. (He loves to answer prayers about the little things too.) They still feel pretty sensitive, and like they would hurt really bad if I caught them on anything, but I have been able to clip them maybe 3 times since the last time I wrote, and every time I do, I feel like I'm a millimeter closer to safety with them. I even dragged my cello out of its case and gave it a try last week, and it wasn't impossible. Except that I haven't practiced since I was diagnosed for whatever reason, so I'm pretty rusty. I wear rubber gloves in the kitchen a lot, when I'm making dinner, cleaning up, or eating a particularly messy meal -because nothing says "Good Nachos" like eating them with rubber gloves on!

I feel like the neuropathy has abated almost completely. As a matter of fact, I sat at the piano and sang and played for a good hour or more this afternoon, and didn't have any issues with my hands. So thank you so much for these prayers. God is truly answering!

#2- Provision: Oh. My. Goodness. You guys are the best. Thank you for everyone who has sent some money our way. We are so appreciative of the sacrifices you have made, and it makes me giddy to see how God provides through the gifts of his people. Four days in a row, we have received OUTRAGEOUS gifts- some anonymous, others not. We are thankful for each and every one. As a result, we celebrated our 21st anniversary (where someone snuck in and paid our bill- leaving in addition $21.21 in cash- which we were then able to leave as an outrageous tip for our cute waitress), and we will be able to meet our household bills for the end of August, as well as pay off the accumulated medical bills that have come our way in the last few weeks. So thank you, thank you, THANK YOU! We are humbled.

This is such a faith builder, when we place our trust in God for provision, and He nudges His people in this way. I would encourage you to trust Him when you are worried. Make your needs known for him, and ask for His help. He is a good Father, and meets the needs of His children. Sometimes, He provides like this, but more often in our lives, He has sent more work our way. Giving your child an opportunity to earn his or her income is a necessary something I do as a parent- why should He be any different?

#3- Platelets: They went up! They were at 142 when they ran labs on me last week. Those prayers did it again! This is not a super-high number, but it's high enough for surgery, and they are moving in the right direction. My liver numbers were a little low, so the doc told me lay off my celebratory drinks. :)  Also to stay away from Tylenol.

Moving Toward Surgery
I am following the pre-surgical protocol, and have not been taking any vitamin or herbal supplements since last Wednesday. My muscles sure got achy for a few days. Probably should have eased off.  I usually take a Vit D3, B Complex, Calcium Carbonate/ Magnesium, some fruit & vegetable juice supplements called Juice Plus, and an herbal supplement for the neuropathy called Neuro-QOL. (No drugs. Isn't that wonderful?) So I am off all that, and my system should be free of all the extras for Wednesday.

I am busily trying to get all my ducks in a row by tomorrow. School started for the kids today, so I'm finalizing carpool schedules, making sure they have all their school supplies, lunch money, etc. I am trying to get my lesson schedules set up, even though I won't go back to teaching until Oct. 1. I have 2 college students doing their senior recitals in September, so I did what I could to help them put finishing touches on that, and now it's up to them. I set up a meal sign-up for anyone local who wants to bring us meals over the next several weeks. I played as many services at our church as I could before taking some time off. Squeezing out the last of my service! Got my small group set up, and my moms' prayer group for school... I hope I'm not missing anything! I'll probably think of something huge at 3 am on Wednesday.

The Big Day
My timeline on Wednesday is arrival at 5:30 am. I was told not to bother being early, because that's when they open. Geesh. Then they are going to do a Sentinel Node Injection at 7 am. That is described as:

...a procedure used to help identify the sentinel lymph node(s), which is the first lymph node to which cancer cells are likely to spread from the primary tumor. The procedure involves injecting a radioactive isotope (technetium sulfur colloid) into the breast, generally around the central aspect of the breast.   The material moves through the lymphatic channels and accumulates in one or several lymph nodes. During surgery, a handheld gamma ray counter scans the area of the underarm to locate the sentinel node(s). ~Source: bannerhealth.com 

Surgery (bilateral simple mastectomies with possible right axillary node dissection) is scheduled for 9:00 am. I told several people it was at 7- I didn't read my admission sheets very thoroughly. Sorry. During surgery, the breast surgeon (Dr. Dosch- if you want to pray for him by name) will remove the breast tissue, and possibly one or two lymph nodes, according to what he sees with the Sentinal Node injection.

Dr. Dosch may also fitz around with my port to make it work properly. It functions at 50% right now, meaning they can use it to put medicine in, but not to draw blood out. They are going to check and see if my insurance will cover that, and if so, he will fix it. If not, he'll leave it alone, and it won't be a huge deal.

Then the plastic surgeon (Dr. Karu) will do her magic. She will begin the reconstruction process by putting tissue expanders behind the pectoral muscles. These are like little water balloons that push the muscles into a new shape. She will pump me up a little bit at at time over the next few months. As you can imagine, the recovery from this surgery is pretty grueling. Think about all the things you use your chest muscles for.... yeah. Everything.

I will probably be in the hospital (Avera McKennan) for two nights, then they anticipate I will be pretty useless for a couple of weeks. They told me to take 4-6 weeks off from work, so I did. Of course, I haven't worked since school got out in May, so I'm anxious to get back, but I'll be fine. I will probably ease back into active life after the first couple of weeks, doing a lesson or two here and there, but I promise not to push it too fast.

My mom is going to come and stay with us for as long as we need her, and of course Matt will do double duty, working and taking care of the kids AND me. He's a super hero.

Prayer Requests:

• One potential complication when they remove any lymph nodes can be
  lymphedema
  , which is a "swelling in the arm that occurs when the normal flow of lymph in the arm is reduced." This would be bad, so let's pray it doesn't happen. The tips my little brochure gives me are to slowly return to normal use, protect hands from infection by wearing gloves and washing hands often (done!), don't wear tight sleeves, elastic cuffs, bracelets, watches or rings on that arm (rings? I... uh. OK), and do some therapy exercises. ~source: "Understanding Breast Cancer" Krames Patient Education.
• Uneventful surgery.
  I would love to be "not weird" for this. I pray for a textbook surgery with no amazing stories for the docs to tell afterward.
• Anesthesia sometimes makes me nauseous.
  It did not when I had my port put in, because I mentioned it to the anesthesiologist. They can add anti-nausea drugs to the drip so that I won't be sick afterward. On a side note, and I think I wrote about this before, but the last time I went under, I tried to pray for the whole group before we got started- but it turned out that the anesthesiologist did such a quick job that I thought I was praying for them before, and they were already done!
• As a singer, I'm always nervous when they intubate me because that tube goes right past the
  vocal cords
  . So protection for those fragile little muscles that I put so much time and energy into.
• And of course,
  recovery. I have given myself plenty of time before I will resume my normal life, but I am sort of a fast mover. You might have noticed that. I don't like sitting around. So I know I need to be patient with myself, and allow time for healing. 

Now, for the "before" picture: 

...and now you know why it was so easy to find a lump the size of a marble.

I know, right? All this fuss over those little things!? I'll leave you with a quote from my ever-encouraging mother. "I don't know what I'm so worried about. As small as you are, it shouldn't be any worse than having a wart removed."